You generally have a guaranteed issue (GI) right when your coverage changes in certain situations. Some of the situations people can encounter are:
1. You have original Medicare and an employer group health plan or union coverage that pays after Medicare pays and that plan is ending – retiree and COBRA coverage is included. You have the option to buy a policy immediately without waiting if you have COBRA (or wait until the coverage ends).
a. In this situation, you have a GI right to buy either a plan A, B, C, F, K, or L from any carrier offering the plans in your state within 63 calendar days after the latest of either:
i. the date the coverage ends
ii. the date on the notice you receive that your coverage is ending (if you receive one)
iii. date on a claim denial notice – if this is the only way you know that your coverage ended
2. Your Medigap insurance company goes bankrupt and you lose your coverage, or your coverage ends through no fault of your own.
a. In this situation, you have a GI right to buy either a plan A, B, C, F, K, or L from any carrier offering the plans in your state within 63 calendar days of the end date of your other policy.
3. You drop your policy because the carrier hasn’t followed the rules or has misled you.
a. In this situation, you have a GI right to buy either a plan A, B, C, F, K, or L from any carrier offering the plans in your state within 63 calendar days of the end date of your other policy.
4. You have Original Medicare and a Medicare SELECT policy and you move out of the policy’s service area.
a. In this situation, you have a GI right to buy either a plan A, B, C, F, K, or L from any carrier offering the plans in your state or the state you are moving to in as early as 60 days before the date your coverage will end, but no later than 63 days after the coverage ends.
There are other scenarios that may provide a guaranteed issue right for your program – for additional input or if you have any questions about Medigap plans or would like a free quote comparison, please feel free to give us a call at 1-888-972-0024. Send us an e-mail by clicking here.